The focus on size, shape and weight can put extreme pressures on dancers. Some dance environments can lead young people into destructive eating habits which may have long-term and even fatal consequences.
As a teacher and role model, you should always be careful when you talk about body size and weight. What you say could be misunderstood or taken to extremes. Teachers of young dancers have a responsibility to be aware of the signs that might indicate problems, and to take steps towards early intervention.
Eating disorders commonly begin with normal dieting that gradually becomes more compulsive. Extreme weight control methods can develop. For example: fasting, bingeing, vomiting, excessive exercise, and overusing diuretics and laxatives.
At a certain point of starvation, the body begins to compensate for the lack of nutrition by cutting out some of its energy demands. Signs might be lack of menstruation, poor blood circulation to hands and feet and inability to concentrate.These drastic behaviours over time can lead to drastic consequences such as cardiac and body chemistry disturbance—and eventually organ failure and death.
What are the signs of eating disorders?
People with eating disorders are usually very clever at hiding and denying their behaviours. Special diets such as vegetarianism, dairy-avoidance etc. can mask an eating disorder. Observe the eating habits of your students and be aware of any changes in weight, appearance and training.
Other signs may include, avoiding eating with others, and loss of interest in social and recreational activities. The teacher could begin some responsible form of investigation, such as inviting the person to an informal lunch to learn about their eating habits. It can also be useful to speak to other students to see whether anyone else has observed unusual behaviours.
Don't be afraid to speak to your students about weight loss or unusual food-related behaviours. By not voicing your concerns, you are contributing to a ‘conspiracy of silence’ that lets students with eating disorders to continue with destructive behaviours that may lead to endangering their lives.
It may take time for the student to acknowledge that they have a problem. It is important to be patient, understanding and persistent with your concerns. If they do not acknowledge that they have a problem, you may need to speak to their parents or carers to share your concerns.
Three steps to talk to your student about an eating disorder:
- show your care and concern
- tell the truth about your observations
- listen to your student’s reactions, and express empathy without being distracted from your concerns.
You should recommend that your student visit their doctor. Treatment may involve a combination of medical monitoring, dietary counselling and psychological help.
Students diagnosed with a mental disorder need medical clearance to take part in activities that involve exercise. Even moderate levels of exercise can result in severe health risk and teachers share the responsibility for safety in these situations. You might need to suspend the student from your dance class to protect their health, until they recover.
What is anorexia nervosa?
Anorexia Nervosa is a psychological illness with devastating physical consequences. Anorexia is characterised by low body weight and body image distortion with an obsessive fear of gaining weight that manifests itself through depriving the body of food. It often coincides with increased levels of exercise and vomiting.
Anorexia is usually developed during adolescence and generally has an earlier age of onset than bulimia and binge eating disorder (the latter are often developed during late adolescence or early adulthood). However like all eating disorders, anorexia can be developed at any age or stage of life for both males and females.
Anorexia is the most fatal of all psychiatric illnesses. Extreme food restriction can lead to starvation, malnutrition and a dangerously low body weight, and in some cases death. A typical anorexic person will severely restrict their food intake. They will maintaining very low calorie count, restrict the types of food eaten, eat only one meal a day, or follow obsessive and rigid rules such as only eating food of one colour.
What is bulimia nervosa?
Bulimia Nervosa is characterised by repeated episodes of binge eating followed by self-induced vomiting; using laxatives, diuretics, enemas, or other medications; fasting; and/or excessive exercise. These behaviours may typically occur perhaps twice a week for months at a time. Self-evaluation is influenced by body shape and weight.
What constitutes binge eating? Eating within any two-hour period an amount of food that is much larger than most people would eat during a similar period of time, and an all-consuming sense of lack of control over eating during the episode.
Bulimics may or may not purge, (i.e. self-induced vomiting or the misuse of laxatives, diuretics, or enemas). Non-purging bulimics will use other behaviours, such as fasting or excessive exercise.
Warning signs
There are behavioural, physical and psychological signs or changes that often accompany an eating disorder. Warning signs may not be easy to detect. People with an eating disorder will generally experience great shame or guilt about their behaviour, and will try to hide it. Some people do not realise they have a problem. Some will not want to give up their behaviour, because it is their way of coping.
If you or somebody you know is experiencing several of the following symptoms, it is important to seek help immediately.
Behavioural
- constant or repetitive dieting (counting calories/kilojoules, skipping meals, fasting, avoiding certain food groups such as meat or dairy, replacing meals with fluids)
- signs of binge eating (large amounts of food disappearing from the cupboard or fridge, lolly wrappers in bin, hoarding food in preparation for bingeing)
- signs of vomiting or laxative abuse (frequent trips to the bathroom during or shortly after meals)
- excessive or compulsive exercise patterns (exercising even when injured, or in bad weather, refusing to stop exercise; insistence on performing a certain number of repetitions of exercises, showing distress if unable to exercise)
- making lists of ‘good’ and ‘bad’ foods
- changes in food preferences (refusing to eat certain foods, claiming to dislike foods previously enjoyed, sudden interest in ‘healthy eating’)
- developing patterns or obsessive rituals around food preparation and eating (eg. insisting that meals must always be at a certain time; only using a certain knife; only drinking out of a certain cup)
- avoiding all social situations involving food
- avoiding eating meals by giving excuses (claiming they have already eaten or have an intolerance/allergy to particular foods)
- behaviours focused around food preparation and planning (shopping for food, planning, preparing and cooking meals for others but not consuming meals themselves; taking control of the family meals; reading cookbooks, recipes, nutritional guides)
- strong focus on body shape and weight (interest in weight-loss websites, dieting tips in books and magazines, images of thin people)
- developing repetitive or obsessive body checking behaviours (pinching waist or wrists, repeated weighing of self, excessive time spent looking in mirrors)
- social withdrawal or isolation from friends, including avavoiding previously enjoyed activities
- change in clothing style, such as wearing baggy or warm clothes
- deceptive behaviour around food, such as secretly throwing food out, eating in secret or lying about amount or type of food consumed
- eating very slowly (eating with teaspoons, cutting food into small pieces and eating one at a time, rearranging food on plate)
- continual denial of hunger
Physical
- sudden or rapid weight loss
- frequent changes in weight
- sensitivity to the cold (feeling cold most of the time)
- loss or disturbance of menstrual periods (females)
- signs of frequent vomiting—swollen cheeks /jawline, calluses on knuckles, or deterioration of teeth
- fainting, dizziness
- fatigue—always feeling tired, unable to perform normal activities
Psychological
- increased preoccupation with body shape, weight and appearance
- intense fear of gaining weight
- constant preoccupation with food or with activities relating to food
- extreme body dissatisfaction/negative body image
- distorted body image (complaining of being/feeling/looking fat when actually a healthy weight or underweight)
- heightened sensitivity to comments or criticism about body shape or weight, eating or exercise habits
- heightened anxiety around meal times
- depression, anxiety
- moodiness or irritability
- low self-esteem (feeling worthless, feelings of shame, guilt or self-loathing)
- rigid ‘black and white’ thinking (viewing everything as either ‘good’ or ‘bad’)
- feelings of life being ‘out of control’
- feelings of being unable to control behaviours around food
- fear of growing up/taking on adult responsibility
Any combination of these symptoms can be present in an eating disorder. It is also possible for a person to demonstrate several of these signs and not have an eating disorder. It is always best to seek a professional opinion.
Addiction
While not all people experiencing an eating disorder will also take part in drug or alcohol abuse, the similar risk factors and personality traits mean that people with an eating disorder are highly susceptible to other addictive behaviours.
Where to get help
The National Butterfly Foundation provides national support for those suffering from eating disorders and negative body image issues, and their carers.
NSW
Centre for Eating & Dieting Disorders (CEDD)
Victoria
Centre of Excellence in Eating Disorders (CEED)
Eating Disorders Foundation of Victoria
Western Australia
Centre for Clinical Interventions (CCI)
ACT
Queensland
Eating Disorder Outreach Services
Isis—The Eating Issues Centre
Tasmania
Tasmania Recovery from Eating Disorders
South Australia
Eating Disorders Association of South Australia Inc.
Acknowledgements
- Safe Dance Project Report by Tony Geeves, Ed.Hilary Trotter Pub. Ausdance 1990
- Jeremy Freeman, Centre for Eating & Dieting Disorders